Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination

Mills, Edward; Jadad, Alejandro R.; Ross, Cory; Wilson, Kumanan

doi:10.1016/j.jclinepi.2005.09.002

Cited by 374Vaccine Coverage and HesitancyPediatric Pain Management TechniquesIntramuscular injections and effects

Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination

Mills, Edward, Jadad, Alejandro R., Ross, Cory, Wilson, Kumanan·2005·Journal of Clinical Epidemiology

DOI 10.1016/j.jclinepi.2005.09.002

Open this paper in CoChat — free account

Abstract

Objective To determine whether a systematic review of qualitative studies can lead to identification of consistent themes across studies, using barriers toward childhood vaccination as an example.Study design and setting We performed a systematic literature search of studies identified in 10 electronic databases. Two independent reviewers selected the relevant abstracts and articles, then extracted information. Content analysis methodology was used to create a coding template for barriers and then to identify how many studies identified specific barriers.Results Fifteen studies were included in this overview. Eight studies used semistructured interviews, five used focus groups, and two used both methodologies. Themes fell under four major headings: issues of harm, issues of distrust, access issues, and other issues. Barriers identified in more than half of the studies included concern about the risk of adverse effects, concern that vaccinations are painful, distrust of by those advocating vaccines (including belief in conspiracy), belief that vaccination should not occur when the child has a minor illness, unpleasant staff or poor communication, and lack of awareness of the vaccination schedule.Conclusion Systematically reviewing qualitative studies on barriers to childhood vaccination provided important information on barriers that are consistently identified by parents in several different studies.

Integrity signals

Registry

Crossref · 10.1016/j.jclinepi.2005.09.002

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Distrust of medical information has been linked to reluctance to vaccinate.
“Further, distrust of medical information has been linked to reluctance to vaccinate [19].”
From The Effects of Anti-Vaccine Conspiracy Theories on Vaccination Intentions (2014) · cites this paper as [19]

Basic content analysis
Weber, R. (1990) · doi:10.4135/9781412983488 · Cited by 7,750 · see citing works
Users' guides to the medical literature
Guyatt, G. H. (1993) · JAMA · doi:10.1001/jama.270.17.2096 · Cited by 2,970 · see citing works
Qualitative Research in Health Care
(2006) · Wiley eBooks · doi:10.1002/9780470750841 · Cited by 2,713 · see citing works
Systematic Reviews: Synthesis of Best Evidence for Clinical Decisions
Cook, D. J., Mulrow, C. D., & Haynes, R. B. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-5-199703010-00006 · Cited by 2,184 · see citing works
Using meta ethnography to synthesise qualitative research: a worked example
Britten, N., Campbell, R., Pope, C., Donovan, J., Morgan, M., & Pill, R. (2002) · Journal of Health Services Research & Policy · doi:10.1258/135581902320432732 · Cited by 1,110 · see citing works
Rationale and Standards for the Systematic Review of Qualitative Literature in Health Services Research
Popay, J., Rogers, A., & Williams, G. (1998) · Qualitative Health Research · doi:10.1177/104973239800800305 · Cited by 987 · see citing works
Users' Guides to the Medical Literature: XXIII. Qualitative Research in Health Care A. Are the Results of the Study Valid?
Giacomini, M. K., Cook, D. J., & for the Evidence-Based Medicine Working Group (2000) · JAMA · doi:10.1001/jama.284.3.357 · Cited by 931 · see citing works
Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care
Campbell, R., Pound, P., Pope, C., Britten, N., Pill, R., Morgan, M., & Donovan, J. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00064-3 · Cited by 921 · see citing works
Quantitative Applications in the Social Sciences
Rand, G. K. (1983) · Journal of the Operational Research Society · doi:10.1057/jors.1983.225 · Cited by 841 · see citing works
Impact of anti-vaccine movements on pertussis control: the untold story
Gangarosa, E., Gałazka, A., Wolfe, C., Phillips, L., Miller, E., Chen, R., & Gangarosa, R. E. (1998) · The Lancet · doi:10.1016/s0140-6736(97)04334-1 · Cited by 749 · see citing works
Meta-Study of Qualitative Health Research: A Practical Guide to Meta-Analysis and Meta-Synthesis
Canam, C., & Thorne, S. (2001) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa.2001.06214fae.007 · Cited by 536 · see citing works
Meta-Synthesis of Qualitative Findings
Jensen, L. A., & Allen, M. N. (1996) · Qualitative Health Research · doi:10.1177/104973239600600407 · Cited by 486 · see citing works
Content and Design Attributes of Antivaccination Web Sites
Wolfe, R. M. (2002) · JAMA · doi:10.1001/jama.287.24.3245 · Cited by 314 · see citing works
Including qualitative research in systematic reviews: opportunities and problems
Dixon‐Woods, M., Fitzpatrick, R. M., & Roberts, K. (2001) · Journal of Evaluation in Clinical Practice · doi:10.1046/j.1365-2753.2001.00257.x · Cited by 298 · see citing works
Qualitative research in systematic reviews
Dixon‐Woods, M., & Fitzpatrick, R. M. (2001) · BMJ · doi:10.1136/bmj.323.7316.765 · Cited by 232 · see citing works
Factors affecting uptake of childhood immunisation: a Bayesian synthesis of qualitative and quantitative evidence
Roberts, K. A., Dixon‐Woods, M., Fitzpatrick, R. M., Abrams, K. R., & Jones, D. R. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11560-1 · Cited by 159 · see citing works
Vaccine preventable diseases and immunisations: a qualitative study of mothers? perceptions of severity, susceptibility, benefits and barriers
Bond, L. M., Nolan, T. M., Pattison, P. E., & Carlin, J. B. (1998) · Australian and New Zealand Journal of Public Health · doi:10.1111/j.1467-842x.1998.tb01411.x · Cited by 146 · see citing works
What Mothers Say About Why Poor Children Fall Behind on Immunizations
Lannon, C. (1995) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1995.02170230024003 · Cited by 109 · see citing works
Increasing Immunization Rates Among Inner-City, African American Children
Wood, D., Halfon, N., Sherbourne, C. D., Mazel, R. M., Schuster, M. A., Hamlin, J. S., Pereyra, M. R., Camp, P., Grabowsky, M., & Duan, N. (1998) · JAMA · doi:10.1001/jama.279.1.29 · Cited by 104 · see citing works
Concerns about immunisation
Bedford, H. E. (2000) · BMJ · doi:10.1136/bmj.320.7229.240 · Cited by 104 · see citing works
Choosing not to immunize: are parents making informed decisions?
Sporton, R. K., & Francis, S.-A. (2001) · Family Practice · doi:10.1093/fampra/18.2.181 · Cited by 101 · see citing works
Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine
Wilson, K. R., Mills, E., Ross, C. P., McGowan, J., & Jadad, A. (2003) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.157.7.628 · Cited by 92 · see citing works
Self-citation
Vaccination levels in Los Angeles public health centers: the contribution of missed opportunities to vaccinate and other factors.
Wood, D., Pereyra, M. R., Halfon, N., Hamlin, J., & Grabowsky, M. (1995) · American Journal of Public Health · doi:10.2105/ajph.85.6.850 · Cited by 74 · see citing works
Perceptions of Vaccine Efficacy, Illness, And Health Among Inner-City Parents
Keane, V. A., STANTON, B. F., Horton, L. A., Aronson, R. E., Galbraith, J. S., & Hughart, N. (1993) · Clinical Pediatrics · doi:10.1177/000992289303200101 · Cited by 45 · see citing works
Parental perceptions of barriers to childhood immunization: results of focus groups conducted in an urban population
McCormick, L. K., Bartholomew, L. K., Lewis, M. J., Brown, M., & Hanson, I. C. (1997) · Health Education Research · doi:10.1093/her/12.3.355 · Cited by 45 · see citing works
Refusals and Delay of Immunization Within Southwest Alberta
Kulig, J. C., Meyer, C. J., Hill, S. A., Handley, C. E., Lichtenberger, S. M., & Myck, S. L. (2002) · Canadian Journal of Public Health · doi:10.1007/bf03404549 · Cited by 34 · see citing works
Low immunisation uptake: Is the process the problem?
Harrington, P. M., Woodman, C., & Shannon, W. F. (2000) · Journal of Epidemiology & Community Health · doi:10.1136/jech.54.5.394 · Cited by 34 · see citing works
Focus Groups Among Public, Military, and Private Sector Mothers: Insights to Improve the Immunization Process
Houseman, C., Butterfoss, F. D., Morrow, A. L., & Rosenthal, J. (1997) · Public Health Nursing · doi:10.1111/j.1525-1446.1997.tb00296.x · Cited by 30 · see citing works
A qualitative analysis of parental decision making for childhood immunisation
Marshall, S., & Swenssen, H. (1999) · Australian and New Zealand Journal of Public Health · doi:10.1111/j.1467-842x.1999.tb01316.x · Cited by 22 · see citing works
Factors influencing the immunization status of children in a rural setting
Wilson, T. (2000) · Journal of Pediatric Health Care · doi:10.1016/s0891-5245(00)70022-8 · Cited by 22 · see citing works
Mothers’ Perceptions of Childhood Immunizations in First Nations Communities of the Sioux Lookout Zone
Tarrant, M., & Gregory, D. (2001) · Canadian Journal of Public Health · doi:10.1007/bf03404842 · Cited by 20 · see citing works
‘As every good mother should’. Childhood immunization in New Zealand: a qualitative study
White, G., & Thomson, A. N. (2007) · Health & Social Care in the Community · doi:10.1111/j.1365-2524.1995.tb00008.x · Cited by 19 · see citing works
The potential of meta-synthesis for nursing care effectiveness research.
Paterson, B. L., & Thorne, S. E. (2003) · PubMed · Cited by 15 · see citing works
Insights on Immunizations From Caregivers of Children Receiving Medicaid‐Funded Services
Evers, D. B. (2000) · Journal for Specialists in Pediatric Nursing · doi:10.1111/j.1744-6155.2000.tb00105.x · Cited by 11 · see citing works
Parents' perceptions of information on immunisations
Austin, H. (2001) · Journal of Child Health Care · doi:10.1177/136749350100500202 · Cited by 9 · see citing works
The 1993 Pertussis Epidemic in Cincinnati
Hardy, I. R. B., Strebel, P. M., Wharton, M. E., & Orenstein, W. A. (1994) · New England Journal of Medicine · doi:10.1056/nejm199411243312114 · Cited by 8 · see citing works
Accounting for public perceptions in the development of a childhood immunisation campaign
McGuire, C. (1990) · Health Education Journal · doi:10.1177/001789699004900305 · Cited by 5 · see citing works

Flagged first, then by citations

Sorted by citations

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.
Tong, A., Sainsbury, P., & Craig, J. (2007) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzm042 · Cited by 42,509 · see citing works
Vaccine hesitancy
Dubé, È., Laberge, C., Guay, M., Bramadat, P. A., Roy, R., & Bettinger, J. A. (2013) · Human Vaccines & Immunotherapeutics · doi:10.4161/hv.24657 · Cited by 2,178 · see citing works
Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review
Herzog, R., Álvarez-Pasquin, M. J., Díaz, C., Del Barrio, J. L., Estrada, J. M., & Gil, Á. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-154 · Cited by 1,652 · see citing works
The Effects of Anti-Vaccine Conspiracy Theories on Vaccination Intentions
Jolley, D., & Douglas, K. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089177 · Cited by 1,232 · see citing works
“suggests that such conspiracy theories tend to feature prominently in focus group discussions about vaccination [19].”
Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies.
Rasmussen, M., Krølner, R. F., Klepp, K., Lytle, L. M., Brug, J., Bere, E. T., & Due, P. (2006) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-3-22 · Cited by 1,096 · see citing works
Increasing Vaccination: Putting Psychological Science Into Action
Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017) · Psychological Science in the Public Interest · doi:10.1177/1529100618760521 · Cited by 1,233 · see citing works
Attitudes to vaccination: A critical review
Yaqub, O., Castle-Clarke, S., Sevdalis, N., & Chataway, J. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2014.04.018 · Cited by 1,089 · see citing works
Communicating with parents about vaccination: a framework for health professionals
Leask, J., Kinnersley, P., Jackson, C., Cheater, F., Bedford, H. E., & Rowles, G. (2012) · BMC Pediatrics · doi:10.1186/1471-2431-12-154 · Cited by 654 · see citing works
COREQ (Consolidated Criteria for Reporting Qualitative Studies)
Booth, A., Hannes, K., Harden, A., Noyes, J., Harris, J., & Tong, A. (2014) · Wiley eBooks · doi:10.1002/9781118715598.ch21 · Cited by 602 · see citing works
Adherence to HAART: A Systematic Review of Developed and Developing Nation Patient-Reported Barriers and Facilitators
Mills, E. J., Nachega, J. B., Bangsberg, D. R., Singh, S., Rachlis, B., Wu, P., Wilson, K., Buchan, I., Gill, C. J., & Cooper, C. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030438 · Cited by 818 · see citing works
Self-citation
A hierarchy of evidence for assessing qualitative health research
Daly, J., Willis, K., Small, R., Green, J., Welch, N., Kealy, M., & Hughes, E. (2007) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2006.03.014 · Cited by 545 · see citing works
Barriers to participation in clinical trials of cancer: a meta-analysis and systematic review of patient-reported factors
Mills, E. J., Seely, D., Rachlis, B., Griffith, L. E., Wu, P., Wilson, K. R., Ellis, P., & Wright, J. R. (2006) · The Lancet Oncology · doi:10.1016/s1470-2045(06)70576-9 · Cited by 536 · see citing works
Self-citation
Evidence-based clinical guidelines for immigrants and refugees
Pottie, K. C., Greenaway, C. A., Feightner, J., Welch, V. A., Swinkels, H. M., Rashid, M., Narasiah, L., Kirmayer, L. J., Ueffing, E., MacDonald, N., et al. (2010) · Canadian Medical Association Journal · doi:10.1503/cmaj.090313 · Cited by 520 · see citing works
A systematic review of factors affecting vaccine uptake in young children
Smith, L., Amlôt, R., Weinman, J. A., Yiend, J., & Rubin, G. J. (2017) · Vaccine · doi:10.1016/j.vaccine.2017.09.046 · Cited by 469 · see citing works
Development of a survey to identify vaccine-hesitant parents
Opel, D. J., Mangione-Smith, R. M., Taylor, J. A., Korfiatis, C., Wiese, C. J., Catz, S. L., & Martin, D. P. (2011) · Human Vaccines · doi:10.4161/hv.7.4.14120 · Cited by 433 · see citing works
Perceived barriers and facilitators towards help‐seeking for eating disorders: A systematic review
Ali, K., Farrer, L. M., Fassnacht, D. B., Gulliver, A., Bauer, S., & Griffiths, K. M. (2016) · International Journal of Eating Disorders · doi:10.1002/eat.22598 · Cited by 427 · see citing works
Acceptance of a pandemic influenza vaccine: a systematic review of surveys of the general public
Wilson, K. R., Nguyen, Henningsen, H., Brehaut, & Hoe (2011) · Infection and Drug Resistance · doi:10.2147/idr.s23174 · Cited by 416 · see citing works
Systematic Review of Barriers to Surgical Care in Low‐Income and Middle‐Income Countries
Grimes, C. E., Bowman, K. G., Dodgion, C. M., & Lavy, C. (2011) · World Journal of Surgery · doi:10.1007/s00268-011-1010-1 · Cited by 415 · see citing works
What does quality of life mean to older adults? A thematic synthesis
van Leeuwen, K. M., van Loon, M. S., van Nes, F., Bosmans, J. E., de Vet, H. C. W., Ket, J. C. F., Widdershoven, G. A. M., & Ostelo, R. (2019) · PLoS ONE · doi:10.1371/journal.pone.0213263 · Cited by 404 · see citing works
Assessment of Youth-Friendly Health Care: A Systematic Review of Indicators Drawn From Young People's Perspectives
Ambresin, A., Bennett, K. E., Patton, G. C., Sanci, L. A., & Sawyer, S. M. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2012.12.014 · Cited by 381 · see citing works
Why Don't Healthcare Professionals Talk About Sex? A Systematic Review of Recent Qualitative Studies Conducted in the United Kingdom
Dyer, K., & das Nair, R. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02856.x · Cited by 375 · see citing works
Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies
Krølner, R. F., Rasmussen, M., Brug, J., Klepp, K., Wind, M., & Due, P. (2011) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-8-112 · Cited by 372 · see citing works
Parents' and informal caregivers' views and experiences of communication about routine childhood vaccination: a synthesis of qualitative evidence
Ames, H. M., Glenton, C., & Lewin, S. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011787.pub2 · Cited by 354 · see citing works
Factors underlying parental decisions about combination childhood vaccinations including MMR: A systematic review
Brown, K. F., Kroll, J. S., Hudson, M. J., Ramsay, M., Green, J., Long, S. J., Vincent, C. A., Fraser, G., & Sevdalis, N. (2010) · Vaccine · doi:10.1016/j.vaccine.2010.04.052 · Cited by 412 · see citing works
Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit
Al Maghaireh, D. F., Abdullah, K. L., Chan, C. M., Piaw, C. Y., & Al Kawafha, M. M. (2016) · Journal of Clinical Nursing · doi:10.1111/jocn.13259 · Cited by 328 · see citing works
A move to more systematic and transparent approaches in qualitative evidence synthesis: update on a review of published papers
Hannes, K., & Macaitis, K. (2012) · Qualitative Research · doi:10.1177/1468794111432992 · Cited by 320 · see citing works
Coronavirus conspiracy suspicions, general vaccine attitudes, trust and coronavirus information source as predictors of vaccine hesitancy among UK residents during the COVID-19 pandemic
Allington, D., McAndrew, S., Moxham-Hall, V. L., & Duffy, B. (2021) · Psychological Medicine · doi:10.1017/s0033291721001434 · Cited by 301 · see citing works
Interventions for improving coverage of childhood immunisation in low- and middle-income countries
Oyo-Ita, A. E., Wiysonge, C. S., Oringanje, C. M., Nwachukwu, C. E., Oduwole, O. A., & Meremikwu, M. M. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008145.pub3 · Cited by 297 · see citing works
Vaccine hesitancy: understanding better to address better
Kumar, D., Chandra, R., Mathur, M., Samdariya, S., & Kapoor, N. (2016) · Israel Journal of Health Policy Research · doi:10.1186/s13584-016-0062-y · Cited by 270 · see citing works
Alternative Vaccination Schedule Preferences Among Parents of Young Children
Dempsey, A. F., Schaffer, S. E., Singer, D., Butchart, A. T., Davis, M. M., & Freed, G. L. (2011) · PEDIATRICS · doi:10.1542/peds.2011-0400 · Cited by 229 · see citing works
Experiences of Parents Who Have Children With Chronic Kidney Disease: A Systematic Review of Qualitative Studies
Tong, A., Lowe, A., Sainsbury, P., & Craig, J. C. (2008) · PEDIATRICS · doi:10.1542/peds.2006-3470 · Cited by 222 · see citing works
Self-Reported Barriers to Medication Adherence Among Chronically Ill Adolescents: A Systematic Review
Hanghøj, S., & Boisen, K. A. (2013) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2013.08.009 · Cited by 211 · see citing works
Systematic review of barriers and facilitators to accessing and engaging with mental health care among at‐risk young people
Brown, A., Rice, S. M., Rickwood, D. J., & Parker, A. G. (2016) · Asia-Pacific Psychiatry · doi:10.1111/appy.12199 · Cited by 274 · see citing works
A systematic review of parent and clinician views and perceptions that influence prescribing decisions in relation to acute childhood infections in primary care
Lucas, P. J., Cabral, C., Hay, A. D., & Horwood, J. P. (2015) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813432.2015.1001942 · Cited by 202 · see citing works
Why parents refuse childhood vaccination: a qualitative study using online focus groups
Harmsen, I. A., Mollema, L., Ruiter, R. A. C., Paulussen, T. G., de Melker, H. E., & Kok, G. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-1183 · Cited by 193 · see citing works
The quality of quality criteria: Replicating the development of the Consolidated Criteria for Reporting Qualitative Research (COREQ)
Buus, N., & Perron, A. (2020) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2019.103452 · Cited by 190 · see citing works
Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews
Fournet, N., Mollema, L., Ruijs, W. L. M., Harmsen, I. A., Keck, F., Durand, J. Y., da Cunha, M. I. P., Wamsiedel, M., Reis, R., French, J., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5103-8 · Cited by 179 · see citing works
Factors Influencing Professional Help-Seeking for Suicidality: A Systematic Review
Han, J., Batterham, P. J., Calear, A. L., & Randall, R. (2018) · Crisis · doi:10.1027/0227-5910/a000485 · Cited by 176 · see citing works
Exposing concerns about vaccination in low- and middle-income countries: a systematic review
Muñoz, D. C., Llamas, L. M., & Bosch‐Capblanch, X. (2015) · International Journal of Public Health · doi:10.1007/s00038-015-0715-6 · Cited by 160 · see citing works
Determinants of effective vaccine coverage in low and middle-income countries: a systematic review and interpretive synthesis
Phillips, D. E., Dieleman, J. L., Lim, S. S., & Shearer, J. (2017) · BMC Health Services Research · doi:10.1186/s12913-017-2626-0 · Cited by 162 · see citing works
A systematic review of surgeon–patient communication: Strengths and opportunities for improvement
Levinson, W. S., Hudak, P. L., & Tricco, A. C. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.03.023 · Cited by 159 · see citing works
The defining characteristics of Web 2.0 and their potential influence in the online vaccination debate
Witteman, H. O., & Zikmund‐Fisher, B. J. (2011) · Vaccine · doi:10.1016/j.vaccine.2011.12.039 · Cited by 158 · see citing works
Vaccine Rejecting Parents’ Engagement With Expert Systems That Inform Vaccination Programs
Attwell, K., Leask, J., Meyer, S. B., Rokkas, P., & Ward, P. (2016) · Journal of Bioethical Inquiry · doi:10.1007/s11673-016-9756-7 · Cited by 157 · see citing works
Hurdles to herd immunity: Distrust of government and vaccine refusal in the US, 2002–2003
Lee, C. M., Whetten, K., Omer, S. B., Pan, W., & Salmon, D. A. (2016) · Vaccine · doi:10.1016/j.vaccine.2016.06.048 · Cited by 146 · see citing works
Desperately Seeking Dissonance
Booth, A., Carroll, C., Ilott, I., Low, L. L., & Cooper, K. L. (2012) · Qualitative Health Research · doi:10.1177/1049732312466295 · Cited by 142 · see citing works
Qualitative studies of insomnia: Current state of knowledge in the field
Araújo, T., Jarrin, D. C., Leanza, Y., Vallières, A., & Morin, C. M. (2016) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2016.01.003 · Cited by 147 · see citing works
The influence of social norms on the dynamics of vaccinating behaviour for paediatric infectious diseases
Oraby, T. F., Thampi, V. A., & Bauch, C. T. (2014) · Proceedings of the Royal Society B Biological Sciences · doi:10.1098/rspb.2013.3172 · Cited by 139 · see citing works
Factors that influence parents' and informal caregivers' views and practices regarding routine childhood vaccination: a qualitative evidence synthesis
Cooper, S., Schmidt, B., Sambala, E. Z., Swartz, A., Colvin, C. J., Leon, N., & Wiysonge, C. S. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013265.pub2 · Cited by 152 · see citing works
Breastfeeding for procedural pain in infants beyond the neonatal period
Harrison, D. M., Reszel, J., Bueno, M., Sampson, M., Shah, V. S., Taddio, A., Larocque, C., & Turner, L. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011248.pub2 · Cited by 136 · see citing works
A meta-synthesis study of the key elements involved in childhood vaccine hesitancy
Crescitelli, M. E. D., Ghirotto, L., Sisson, H., Sarli, L., Artioli, G., Bassi, M. C., Appicciutoli, G., & Hayter, M. (2019) · Public Health · doi:10.1016/j.puhe.2019.10.027 · Cited by 135 · see citing works
How Physicians Allocate Scarce Resources at the Bedside: A Systematic Review of Qualitative Studies
Strech, D., Synofzik, M., & Marckmann, G. (2008) · The Journal of Medicine and Philosophy A Forum for Bioethics and Philosophy of Medicine · doi:10.1093/jmp/jhm007 · Cited by 130 · see citing works
Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews
Kaufman, J., Tuckerman, J., Bonner, C., Dürrheim, D. N., Costa, D. S. J., Trevena, L. J., Thomas, S. L., & Danchin, M. H. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2021-006860 · Cited by 126 · see citing works
UK parents’ decision-making about measles–mumps–rubella (MMR) vaccine 10 years after the MMR-autism controversy: A qualitative analysis
Brown, K., Long, S. J., Ramsay, M. E., Hudson, M. J., Green, J., Vincent, C. A., Kroll, J. S., Fraser, G. M., & Sevdalis, N. (2012) · Vaccine · doi:10.1016/j.vaccine.2011.12.127 · Cited by 124 · see citing works
Parents' decision-making regarding vaccinating their children against influenza: A web-based survey
Flood, E. M., Rousculp, M. D., Ryan, K. J., Beusterien, K. M., Divino, V. M., Toback, S. L., Sasané, M., Block, S. L., Hall, M. C., & Mahadevia, P. J. (2010) · Clinical Therapeutics · doi:10.1016/j.clinthera.2010.06.020 · Cited by 122 · see citing works
Barriers to immunization among newcomers: A systematic review
Wilson, L. A., Rubens-Augustson, T., Murphy, M. S. Q., Jardine, C., Crowcroft, N. S., Hui, C. P., & Wilson, K. R. (2018) · Vaccine · doi:10.1016/j.vaccine.2018.01.025 · Cited by 120 · see citing works
Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review
Ekezie, W. C., Awwad, S., Krauchenberg, A., Karara, N., Dembiński, Ł., Grossman, Z., del Torso, S., Dornbusch, H. J., Neves, A., Copley, S., et al. (2022) · Vaccines · doi:10.3390/vaccines10071038 · Cited by 126 · see citing works
Understanding impediments and enablers to physical activity among African American adults: a systematic review of qualitative studies
Siddiqi, Z., Tiro, J. A., & Shuval, K. (2011) · Health Education Research · doi:10.1093/her/cyr068 · Cited by 119 · see citing works
Qualitative systematic review: barriers and facilitators to smoking cessation experienced by women in pregnancy and following childbirth
Flemming, K., McCaughan, D., Angus, K., & Graham, H. M. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12580 · Cited by 116 · see citing works
Parental reminder, recall and educational interventions to improve early childhood immunisation uptake: A systematic review and meta-analysis
Harvey, H., Reissland, N., & Mason, J. M. (2015) · Vaccine · doi:10.1016/j.vaccine.2015.04.085 · Cited by 115 · see citing works
Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee
National Vaccine Advisory Committee (2015) · Public Health Reports · doi:10.1177/003335491513000606 · Cited by 114 · see citing works
Measuring vaccine acceptance among Canadian parents: A survey of the Canadian Immunization Research Network
Dubé, È., Gagnon, D., Ouakki, M., Bettinger, J. A., Witteman, H. O., MacDonald, S. E., Fisher, W. A., Saini, V., & Greyson, D. L. (2017) · Vaccine · doi:10.1016/j.vaccine.2017.12.005 · Cited by 113 · see citing works
How orthodox protestant parents decide on the vaccination of their children: a qualitative study
Ruijs, W. L. M., Hautvast, J. L. A., van IJzendoorn, G., van Ansem, W. J. C., van der Velden, K., & Hulscher, M. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-408 · Cited by 113 · see citing works
Factors underlying suboptimal childhood immunisation
Tickner, S., Leman, P. J., & Woodcock, A. J. (2006) · Vaccine · doi:10.1016/j.vaccine.2006.06.060 · Cited by 112 · see citing works
Informal caring for stroke survivors: Meta-ethnographic review of qualitative literature
Greenwood, N., & Mackenzie, A. (2010) · Maturitas · doi:10.1016/j.maturitas.2010.03.017 · Cited by 109 · see citing works
Flavored Tobacco Products in the United States: A Systematic Review Assessing Use and Attitudes
Feirman, S. P., Lock, D., Cohen, J. E., Holtgräve, D. R., & Li, T. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv176 · Cited by 108 · see citing works
Examining inequalities in the uptake of the school-based HPV vaccination programme in England: a retrospective cohort study
Fisher, H., Audrey, S., Mytton, J. A., Hickman, M., & Trotter, C. L. (2013) · Journal of Public Health · doi:10.1093/pubmed/fdt042 · Cited by 107 · see citing works
Trust in physicians and trust in government predict COVID‐19 vaccine uptake
Viskupič, F., Wiltse, D. L., & Meyer, B. A. (2022) · Social Science Quarterly · doi:10.1111/ssqu.13147 · Cited by 121 · see citing works
Anti-Vaccination Beliefs and Unrelated Conspiracy Theories
Goldberg, Z. J., & Richey, S. (2020) · World Affairs · doi:10.1177/0043820020920554 · Cited by 59 · see citing works
Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies
Maslove, D. M., Mnyusiwalla, A., Mills, E. J., McGowan, J., Attaran, A., & Wilson, K. R. (2009) · BMC International Health and Human Rights · doi:10.1186/1472-698x-9-26 · Cited by 104 · see citing works
Self-citation
Interventions aimed at communities to inform and/or educate about early childhood vaccination
Sæterdal, I., Lewin, S. A., Austvoll‐Dahlgren, A., Glenton, C., & Munabi-Babigumira, S. K. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010232.pub2 · Cited by 102 · see citing works
Omission bias and vaccine rejection by parents of healthy children: Implications for the influenza A/H1N1 vaccination programme
Brown, K., Kroll, J. S., Hudson, M. J., Ramsay, M. E., Green, J., Vincent, C. A., Fraser, G. M., & Sevdalis, N. (2010) · Vaccine · doi:10.1016/j.vaccine.2010.04.012 · Cited by 101 · see citing works
A taxonomy of reasoning flaws in the anti-vaccine movement
Jacobson, R. M., Targonski, P. V., & Poland, G. A. (2007) · Vaccine · doi:10.1016/j.vaccine.2007.01.046 · Cited by 99 · see citing works
Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment
Adams, J. M., Bateman, B., Becker, F., Cresswell, T., Flynn, D., McNaughton, R. J., Oluboyede, Y., Robalino, S., Ternent, L., Gardner, B., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19940 · Cited by 99 · see citing works
Barriers to the participation of men in reproductive health care: a systematic review and meta-synthesis
Roudsari, R. L., Sharifi, F., & Goudarzi, F. (2023) · BMC Public Health · doi:10.1186/s12889-023-15692-x · Cited by 99 · see citing works
An internet-based survey on parental attitudes towards immunization
Heininger, U. (2006) · Vaccine · doi:10.1016/j.vaccine.2006.05.029 · Cited by 97 · see citing works
Chapter 20: Qualitative research and Cochrane reviews
Noyes, J., Popay, J., Pearson, A., Hannes, K., & Booth, A. (2008) · Cited by 96 · see citing works
Global assessment of national mandatory vaccination policies and consequences of non-compliance
Gravagna, K., Becker, A., Valeris-Chacin, R. J., Mohammed, I. S., Tambe, S., Awan, F. A., Toomey, T. L., & Basta, N. E. (2020) · Vaccine · doi:10.1016/j.vaccine.2020.09.063 · Cited by 95 · see citing works
Are physicians willing to ration health care? Conflicting findings in a systematic review of survey research
Strech, D., Persad, G., Marckmann, G., & Danis, M. (2008) · Health Policy · doi:10.1016/j.healthpol.2008.10.013 · Cited by 95 · see citing works
Mistrust of the medical profession and higher disgust sensitivity predict parental vaccine hesitancy
Reuben, R. B., Aitken, D., Freedman, J. L., & Einstein, G. (2020) · PLoS ONE · doi:10.1371/journal.pone.0237755 · Cited by 98 · see citing works
I Immunise: An evaluation of a values-based campaign to change attitudes and beliefs
Attwell, K., & Freeman, M. L. (2015) · Vaccine · doi:10.1016/j.vaccine.2015.09.092 · Cited by 93 · see citing works
Considerações sobre o impacto da covid-19 na relação indivíduo-sociedade: da hesitação vacinal ao clamor por uma vacina
Couto, M. T., Barbieri, C. L. A., & Matos, C. C. D. S. A. (2021) · Saúde e Sociedade · doi:10.1590/s0104-12902021200450 · Cited by 108 · see citing works
Systematic reviews of empirical bioethics
Strech, D., Synofzik, M., & Marckmann, G. (2008) · Journal of Medical Ethics · doi:10.1136/jme.2007.021709 · Cited by 84 · see citing works
Beliefs in conspiracy theories, intolerance of uncertainty, and moral disengagement during the coronavirus crisis
Maftei, A., & Holman, A. C. (2020) · Ethics & Behavior · doi:10.1080/10508422.2020.1843171 · Cited by 86 · see citing works
Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study
Bauld, L., Graham, H. M., Sinclair, L., Flemming, K., Naughton, F., Ford, A., McKell, J., McCaughan, D., Hopewell, S., Angus, K., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21360 · Cited by 83 · see citing works
Misperceptions About Influenza Vaccination Among Parents of Healthy Young Children
Daley, M. F., Crane, L. A., Chandramouli, V., Beaty, B. L., Barrow, J. C., Allred, N. J., Berman, S., & Kempe, A. (2007) · Clinical Pediatrics · doi:10.1177/0009922806298647 · Cited by 84 · see citing works
Systematic Reviews and Librarians
McKibbon, A. (2006) · Library trends · doi:10.1353/lib.2006.0049 · Cited by 84 · see citing works
Anti-vaccination and pro-CAM attitudes both reflect magical beliefs about health
Bryden, G. M., Browne, M., Rockloff, M., & Unsworth, C. A. (2018) · Vaccine · doi:10.1016/j.vaccine.2017.12.068 · Cited by 82 · see citing works
Vaccine Information Sources and Parental Trust in Their Child’s Health Care Provider
Eller, N. M., Henrikson, N. B., & Opel, D. J. (2019) · Health Education & Behavior · doi:10.1177/1090198118819716 · Cited by 81 · see citing works
Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research
Forster, A. S., Rockliffe, L., Chorley, A. J., Marlow, L. A. V., Bedford, H. E., Smith, S. G., & Waller, J. (2016) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2016-207366 · Cited by 80 · see citing works
Opportunities for utilizing new technologies to increase vaccine confidence
Wilson, K. R., Atkinson, K. M., & Deeks, S. L. (2014) · Expert Review of Vaccines · doi:10.1586/14760584.2014.928208 · Cited by 78 · see citing works
Interventions for improving coverage of childhood immunisation in low- and middle-income countries
Oyo-Ita, A. E., Oduwole, O. A., Arikpo, D., Effa, E., Esu, E., Balakrishna, Y., Chibuzor, M. T., Oringanje, C. M., Nwachukwu, C. E., Wiysonge, C. S., et al. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008145.pub4 · Cited by 88 · see citing works
Too many crying babies: a systematic review of pain management practices during immunizations on YouTube
Harrison, D. M., Sampson, M., Reszel, J., Abdulla, K., Barrowman, N., Cumber, J., Fuller, A., Li, C., Nicholls, S. G., & Pound, C. (2014) · BMC Pediatrics · doi:10.1186/1471-2431-14-134 · Cited by 75 · see citing works
Interventions to increase pediatric vaccine uptake: An overview of recent findings
Frew, P. M., & Lutz, C. S. (2017) · Human Vaccines & Immunotherapeutics · doi:10.1080/21645515.2017.1367069 · Cited by 75 · see citing works
Psychological factors associated with uptake of the childhood influenza vaccine and perception of post-vaccination side-effects: A cross-sectional survey in England
Smith, L., Webster, R., Weinman, J. A., Amlôt, R., Yiend, J., & Rubin, G. J. (2017) · Vaccine · doi:10.1016/j.vaccine.2017.02.031 · Cited by 74 · see citing works
Turning Points for Perpetrators of Intimate Partner Violence
Sheehan, K., Thakor, S., & Stewart, D. E. (2011) · Trauma Violence & Abuse · doi:10.1177/1524838011426016 · Cited by 71 · see citing works
The 2009 pandemic H1N1 influenza vaccination in France: who accepted to receive the vaccine and why?
Raude, J., Caille-Brillet, A.-L., & Setbon, M. (2010) · PLoS Currents · doi:10.1371/currents.rrn1188 · Cited by 72 · see citing works
Needles, Jabs and Jags: a qualitative exploration of barriers and facilitators to child and adult immunisation uptake among Gypsies, Travellers and Roma
Jackson, C., Bedford, H. E., Cheater, F., Condon, L., Emslie, C., Ireland, L., Kemsley, P., Kerr, S., Lewis, H., Mytton, J. A., et al. (2017) · BMC Public Health · doi:10.1186/s12889-017-4178-y · Cited by 72 · see citing works
A Review of Barriers to Using Psychiatric Advance Directives in Clinical Practice
Shields‐Zeeman, L., Pathare, S., van der Ham, A. J., & Bunders, J. (2013) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-013-0523-3 · Cited by 70 · see citing works
Vaccinations in Primary Care
Shukla, V. V., & Shah, R. C. (2018) · The Indian Journal of Pediatrics · doi:10.1007/s12098-017-2555-2 · Cited by 70 · see citing works
Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents
Taddio, A., Shah, V. S., Leung, E. Y. M., Wang, J., Parikh, C., Smart, S., Hetherington, R., Ipp, M., Riddell, R. P., Sgro, M. D., et al. (2013) · BMC Pediatrics · doi:10.1186/1471-2431-13-23 · Cited by 68 · see citing works

Practice Implications
(2004) · Child Abuse & Neglect · doi:10.1016/s0145-2134(04)00028-6
Systematically reviewing qualitative studies complements survey design: An exploratory study of barriers to paediatric immunisations
Mills, E. J., Montori, V. M., Ross, C. P., Shea, B., Wilson, K. R., & Guyatt, G. H. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.01.014 · Cited by 49 · see citing works
Self-citation
Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews
Kaufman, J., Tuckerman, J., Bonner, C., Dürrheim, D. N., Costa, D. S. J., Trevena, L. J., Thomas, S. L., & Danchin, M. H. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2021-006860 · Cited by 126 · see citing works
PARENTAL PERCEPTION OF CHILDHOOD VACCINATION: A QUALITATIVE STUDY
Koshmaganbetova, G. K., Taikesheva, D. Z., Utemuratov, A. M., Ablakimova, N., Grjibovski, A. M., & Zhylkybekova, A. (2026) · Ġylym men densaulyķ saķtau. · doi:10.34689/sh.2026.28.1.015
Beliefs around childhood vaccines in the United States: A systematic review
Gidengil, C. A., Chen, C., Parker, A. M., Nowak, S. A., & Matthews, L. J. (2019) · Vaccine · doi:10.1016/j.vaccine.2019.08.068 · Cited by 89 · see citing works

Authors: Mills, E., Jadad, A. R., Ross, C., & Wilson, K.
Affiliations: University of Oxford (GB)
University Health Network (CA)
Queen Margaret University (GB)
Corresponding author: Wilson, Kumanan
ORCID: Mills, Edward
Jadad, Alejandro R.
Wilson, Kumanan
Venue: Journal of Clinical Epidemiology
Publisher: Elsevier BV
Published: 2005-11
Volume: 58
Issue: 11
Pages: 1081-1088
ISSN: 0895-4356 (ISSN-L)
DOI: 10.1016/j.jclinepi.2005.09.002
OpenAlex: W1994034662
Cited by: 374
References: 37
Citations by year: 2026: 2 · 2025: 5 · 2024: 17 · 2023: 20 · 2022: 15 · 2021: 22 · 2020: 18 · 2019: 22 · 2018: 17 · 2017: 27 · 2016: 28 · 2015: 32 · 2014: 36 · 2013: 21 · 2012: 16
FWCI: 1.46
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Clinical Epidemiology (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research
Topics: Social Sciences › Health › Vaccine Coverage and Hesitancy
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Health Sciences › Medicine › Emergency Medicine › Intramuscular injections and effects
Keywords: childhood immunization, parental beliefs, vaccine hesitancy, barriers to vaccination, vaccine safety concerns, vaccination pain, conspiracy beliefs, health communication, vaccine access
MeSH terms: Adult, Attitude, Child, Culture, Data Interpretation, Statistical, Humans, Parents, Vaccination, Epidemiologic Research Design

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Systematic review of qualitative studies exploring parental beliefs and attitudes toward childhood vaccination identifies common barriers to vaccination

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks